Application Form CCB Seminar

Personal Information

First name

Surname

Date of birth

E-Mail Used as correspondence address.

Phone number Mobile or landline

Place of origin Please list city, state and country.

I register for the following seminar Please select Track 1 or 2

Most recent qualification

Current occupation / position

Practical experience (after completing education)

How did you hear about the seminar?

Billing address

Private Company

Private address Street, Number, PLZ, Place

Company name and address Name, Street, Number, PLZ, Place

Previously attended relevant continuing education programmes

Confirmation

Without your further consent, the data sent will only be used for the purposes of processing your request. You can find more information on the Legal page.

Regulations

Confirmation I hereby confirm that the Information stated is correct and I accept the FHNW regulations for continuing education programmes.

Yes

Data policy We would like to tell you about what is happening at FHNW in the future but require your con-sent to do so.

I would like to receive further information. I don't want to receive further information.

Continuing Education

Life Sciences

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